Sec tion 2
Stakeholder Analysis
Guidelines
Table of Contents
Introduction . . . 2-1 Step 1: Planning the Process . . . 2-3 Step 2: Selecting and Defining a Policy. . . 2-5 Step 3: Identifying Key Stakeholders . . . 2 -6 Step 4: Adapting the Tools . . . 2-8 Step 5: Collecting and Recording the Inform ation . . . 2-13 Step 6: Filling in the Stakeholder Table . . . 2-15 Step 7: Analyzing the Stakeholder Table . . . 2-19 Step 8: Using the Inform ation . . . 2 -23 Bibliography. . . 2-33 Annex 2-A: Sam ple General List of Stakeholders . . . 2-34 Annex 2-B: Definitions of Stakeholder Characteristics and
Instructions for Filling in Stakeholder Table. . . 2-35 Annex 2-C: Sam ple Stakeholder Table . . . 2-38 Annex 2-D: Sam ple Stakeholder Interview Questionnaire . . . 2-40 Annex 2-E: Sam ple Inform ation Transfer Reference Chart . . . 2-43
List of Boxes, Figur es, and Tables
Box 2.1. Sam ple policies . . . 2 -5 Box 2.2. Sam ple health reform policy definitions . . . 2-5 Box 2.3. Potential stakeholder groups for a
Box 2.6. Sam ple general strategies for increasing
support for deconcentration of the MOH. . . 2-30
Figure 2.1. The Policy Process . . . 2-2 Figure 2.2. Spectrum of Stakeholder Positions . . . 2-16 Figure 2.3. Use All Tools in Filling in the Analysis Table
( See Annexes for full versions) . . . 2-18 Figure 2.4. Sam ple of How to Use PowerPoint to Present
Power/Leadership Analysis Results . . . 2-24 Figure 2.5. Sam ple Position Map . . . 2-25 Figure 2.6. PowerPoint Presentation of Knowledge Data . . . 2-27 Figure 2.7. PowerPoint Presentation of Key Alliances . . . 2-28 Figure 2.8. Sam ple Presentation of Strategies in PowerPoint. . . 2-30 Figure 2.9. Matrix for Identifying Stakeholders to
Be Targeted by Strategies . . . 2-32
Table 2.1. Stakeholder Characteristics and Table Titles
( full table in Annex 2-C) . . . 2-9 Table 2.2. Reference Chart ( question num bers
Glance
What Is Stakeholder Analysis?
Stakeholder analysis is a process of system atically gathering and analyzing qualitative infor-mation to determ ine whose interests should be taken into account when developing and/or im plem enting a policy or program .
Who Is a Stakeholder ?
Stakeholders in a process are actors ( persons or organizations) with a vested interest in the pol-icy being prom oted. These stakeholders, or “interested parties,” can usually be grouped into the following categories: international/donors, national political ( legislators, governors) , public ( m inistry of health [ MOH] , social security agency, m inistry of finance) , labor ( unions, m edical associations) , com m ercial/private for-profit, nonprofit ( nongovernm ental organizations [ NGOs] , foundations) , civil society, and users/consum ers.
Which Stakeholder Char acter istics Ar e Analyzed?
The analysis includes such stakeholder characteristics as knowledge of the policy, interests related to the policy, position for or against the policy, potential alliances with other stakeholders, and ability to affect the policy process ( through power and/or leadership) .
Why Is this Analysis Useful?
What Ar e the Steps in Stakeholder Analysis?
There are eight m ajor steps in the process:
1. Planning the process
2. Selecting and defining a policy
3. Identifying key stakeholders
4. Adapting the tools
5. Collecting and recording the inform ation
6. Filling in the stakeholder table
7. Analyzing the stakeholder table
8. Using the inform ation
What Can Be Achieved with Stakeholder Analysis?
Stakeholder analysis yields useful and accurate inform ation about those persons and organiza-tions that have an interest in health reform . This inform ation can be used to provide input for other analyses; to develop action plans to increase support for a reform policy; and to guide a participatory, consensus-building process.
Stakeholder Analysis
Guidelines
Intr oduction
In developing this docum ent, Partnerships for Health Reform ( PHR) addresses one aspect of m anaging the “politics” of the reform process: the need for inform ation on key players who have an investm ent in proposed reform s. This is particularly im portant at the policy form ula-tion and legitim aula-tion phase of the policy process ( see Figure 2.1) .Policym akers and m anagers can use stakeholder analysis to identify these key players or “stakeholders,” predict whether they m ight support or block the im plem entation of health reform s, and develop strategies to pro-m ote supportive actions and decrease opposing actions b efore attem pting to im plem ent m ajor reform at the national, regional, local, or facility level.
The purpose of this docum ent is to help policym akers, m anagers, and their working groups follow an “objective” and system atic process for collecting and analyzing data about key health reform stakeholders. It should be noted, however, that even the application of the system atic m ethodology incorporated into these guidelines cannot prevent the inform ation from being som ewhat subjective since stakeholder analysis is based on what stakeholders com m unicate to analysts. These guidelines, however, do include suggestions for checking the consistency of answers and other m echanism s to ensure that the inform ation is obtained and analyzed as objectively as possible.
This docum ent was developed using a thorough review of the literature on stakeholder anal-ysis, political m apping, and policy process, as well as PHR field experience in conducting stake-holder analyses. ( Health reform stakestake-holder analyses were conducted with PHR support in Ecuador and India.) The resulting docum ent, therefore, includes instructions and tools that are supported by both academ ic theory and real-world application.
These guidelines incorporate a m ethodology that yields useful and accurate inform ation on health reform stakeholders ( and can be followed even when conducting a stakeholder analysis with lim ited tim e or resources) . The inform ation resulting from the analysis can be used for the following:
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Develop action plans to increase support for a reform policy
Guide a participatory, consensus-building process ( by sharing the inform ation obtained with the stakeholders and encouraging discussion about how to address the concerns of the opposition) .
Application of these guidelines is intended to m ake policym akers and m anagers m ore inform ed about the political environm ent surrounding their reform s and better prepared to take action to ensure the full im plem entation of health sector reform s.
To increase support or build consensus for reform , policym akers and m anagers m ust take additional steps following the stakeholder analysis. In the next phases of the policy process— constituency-building, resource m obilization, and im plem entation ( Figure 2.1) — policym ak-ers and m anagak-ers should use the inform ation generated by the stakeholder analysis to develop and im plem ent strategic com m unication, advocacy, and negotiation plans. The other sections of this toolkit can be used to guide the developm ent and im plem entation of such plans ( see, for exam ple, Section 3: Advocacy Guidelines, and Section 4: Conflict Negotiation Guidelines) .
Figur e 2 .1 . The Policy Pr ocess
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Step 1 : Planning the Pr ocess
Define the pur pose of the analysis, and identify uses for the
r esults.
The first step in conducting a stakeholder analysis is to define the purpose of the analysis, iden-tify the potential users of the inform ation, and devise a plan for using the inform ation. A discus-sion of these issues should be led by the “sponsor,” or initiator, of the stakeholder analysis.
As noted above, inform ation generated from stakeholder analysis m ay serve several pur-poses: to provide input for other analyses; to inform the developm ent of action plans to increase support for a reform policy; or to guide a participatory, consensus-building process.
Other activities, such as strategic planning, institutional assessm ents, or application of com -puterized program s like PolicyMaker,1 often require the type of inform ation produced by a stakeholder analysis— who the stakeholders are, what their positions are related to a policy, how im portant they are, and so forth. It m ay be useful, therefore, to conduct a stakeholder anal-ysis in conjunction with these activities.
Policym akers and m anagers m ay use the results of a stakeholder analysis to develop their action plans. These plans should identify concrete actions, and possibly “behind the scenes” activities, that the policym akers and m anagers will im plem ent to increase stakeholder support.
Finally, policym akers and m anagers m ay use the results in open discussions with stakehold-ers in an effort to build consensus. This allows stakeholdstakehold-ers to see where they are relative to oth-ers and encourages discussion on how to address the opposition’s concerns. This m ay be useful when the num ber of stakeholders is sm all and m anageable and when consensus-building is a stated goal of the analysis.
Before proceeding with the next steps, the sponsor should ensure that a consensus exists am ong the policym akers as to the purpose of the analysis, its proposed users, and the intended use of the results.
Identify and tr ain a wor king gr oup.
The sponsor of the activity should form a sm all “working group” ( two to four people) whose m em bers will be the interviewers and analysts for the stakeholder analysis. The sponsor m ay guide the process and serve as a point of reference, or he or she m ay be a m em ber— even the leader— of the working group.
Whenever possible, the working group should represent distinct interests and organizations. This helps prevent the type of biases that can occur when a single person or institution conducts an analysis. Having m em bers with differing points of view can also be helpful in interpreting the qualitative and, at tim es, am biguous data that em erge. If possible, the group should include
2 -4 Policy Toolkit for Strengthening Health Sec tor Reform
a “neutral” person who has no political or other interest in the policy and who is independent of the institution prom oting the policy. It is also useful to include m em bers who are knowledge-able about the sector, stakeholders, context, and politics related to the policy.
The stakeholder analysis process should be participatory, involving all m em bers of the work-ing group from beginnwork-ing to end. This way, all workwork-ing group m em bers will be integrated into the entire process and will gain the experience needed to conduct sim ilar efforts in the future. Integrating all working group m em bers into the process also will increase their understanding of and support for the results and help them accurately translate the interview responses into analysis results.
It is im portant that m em bers of the working group are experienced as interviewers and are able to elicit answers to the stated questions without im posing their personal biases. If they have no previous experience, a day or two of training m ay be required ( such as practice interviewing through role playing) . The working group m em bers also should be able to review and accu-rately synthesize qualitative inform ation. In addition, all m em bers of the group should read these stakeholder analysis guidelines, receive training on the content of stakeholder analysis, and understand the reason for undertaking the analysis.
Develop a plan and timeline.
Step 2 : Selecting and Defining a Policy
Select an appr opr iate policy.
For a stakeholder analysis to be useful, it m ust be focused on a specific policy or issue. Again, policy is used in this docum ent to refer to any national, regional, local, or institutional project, program , law, regulation, or rule. In m ost cases, the sponsor of the stakeholder analysis will have identified a policy, but it is im portant to ensure that the policy in question is an appropri-ate topic for a stakeholder analysis before the process begins.
The following are som e basic criteria for evaluating the appropriateness of health reform policies as subjects of a stakeholder analysis:
The policy should be specific and “definable.” Policym akers and m anagers should avoid conducting an analysis on a poli-cy that has not been thought through or is too general to be de-fined in concrete term s. This is im portant to ensure that specif-ic interview questions and responses can be developed around the policy.
The policy should be socially and politically controversial so that it m erits the investm ent of resources required to determ ine what aspects are controversial and to whom .
The policy should be key to current reform efforts and im portant enough to justify the resources that will be needed to im -plem ent recom m ended actions that em erge from the analysis.
Define the policy.
Once a policy is chosen for the stakeholder analysis, the working group should work with policym akers to define the m ain ideas and concepts. The basic ideas, not the details of the policy, will need to be explained to the stakeholders later in the process, and sim ple, concise definitions will be required.
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Step 3 : Identifying Key Stakeholder s
Identifying the key stakeholders is extrem ely im portant to the success of the analysis. Based on the resources available, the working group should decide on the m axim um num ber of stake-holders to be interviewed. The working group should then follow the steps below to define the list of stakeholders ( beginning with an open list that can be reduced, if necessary) .
Compile and r eview existing infor mation.
The working group should gather and analyze any written docum ents related to the selected pol-icy. This will help to identify potential stakeholders and, perhaps, their connection to the polpol-icy.
Develop a list of all possible stakeholder s.
Initially, the working group should identify all actors who could have an interest in the selected policy, including actors outside the health sector that could affect or be affected by the policy. Specific stakeholders can be identified from the follow-ing sectors: international/donors, national political ( legisla-tors, governors) , public ( m inistry of health [ MOH] , social security agency, m inistry of finance) , labor ( unions, m edical associations) , com m ercial/private for-profit, and nonprofit ( nongovernm ental organizations [ NGOs] , foundations) . Civil society is an im portant sector to consider if the com m unity or consum ers have a direct interest in the policy. It is also im por-tant to consider the potential stakeholders in different geo-graphic or adm inistrative areas within one organization.
Develop a list of pr ior ity stakeholder s with
input fr om exper ts.
Since resources, tim e, and finances for the analysis will be lim -ited, the list of stakeholders to be interviewed m ust be priori-tized. Experts who know the sector, policy, and players can help in this process.
The working group should consult with two to three persons who have extensive knowledge of the health sector, its actors, and the power of those actors to influence the policy. Experts could be representatives from donor organizations, health reform projects, a national health council, private consulting firm s that have worked in health, or other sector-wide organiza-tions. They could also be persons who have worked in various positions in the health sector, such as ex-MOH authorities. Ideally, these experts should not be stakeholders them selves.
related to or affected by the particular policy and that have the ability to affect the im plem enta-tion of the policy.
The working group also should ask experts about the availability of written inform ation, including specific stakeholder statem ents related to the policy. Such written docum ents m ay not provide the working group with all the inform ation necessary to identify the m ost appropriate stakeholders, but they will m ake the working group selections m ore inform ed.
Using the experts’ input, the working group should prioritize the list of potential stakehold-ers to include only those individuals who have a direct interest in the policy and could affect its im plem entation. Actors who are not organized or do not have the ability to affect the specific policy should not be included.
Annex 2-A lists the general groups from which stakeholders for a health financing policy m ay be identified, as well as j ustifications for their inclusion. This list m ay vary by country and policy, but including a j ustification for the inclusion of stakeholders ensures that only those directly related to the policy are selected.
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Step 4 : Adapting the Tools
Generally, very little secondary inform ation is available on stakeholders. As a result, the working group should plan to interview the priority stakeholders identified to gain accurate inform ation on their positions, interests, and ability to affect the process.
The following tools can be used for gathering and analyzing this inform ation:
Definitions of stakeholder characteristics ( See Annex 2-B) Stakeholder table ( See Annex 2-C)
Interview questionnaire and protocol ( See Annex 2-D) Reference chart ( See Annex 2-E)
The working group should review and adapt these tools to fit the specific policy being ana-lyzed and the policym akers’ inform ation needs.
Adapt stakeholder char acter istics.
The working group should define the exact stakeholder inform ation or characteristics to be considered. The following characteristics are usually included for each stakeholder ( each of these term s is defined further in Annex 2-B) :
I.D. num ber ( given to the stakeholder on the questionnaire) Position and organization
Internal/external: internal stakeholders work within the organization that is prom oting or im plem enting the policy; all other stakeholders are external.
Knowledge of policy: the level of accurate knowledge the stakeholder has regarding the pol-icy under analysis, and how each stakeholder defines the polpol-icy in question. This is im por-tant for identifying stakeholders who oppose the policy due to m isunderstandings or lack of inform ation.
Position: whether the stakeholder supports, opposes, or is neutral about the policy, which is key to establishing whether or not he or she will block the policy im plem entation
Interest: the stakeholder’s interest in the policy, or the advantages and disadvantages that im plem entation of the policy m ay bring to the stakeholder or his or her organization. Deter-m ining the stakeholder’s vested interests helps policyDeter-m akers and Deter-m anagers better under-stand his or her position and address his or her concerns.
Alliances: organizations that collaborate to support or oppose the policy. Alliances can m ake a weak stakeholder stronger, or provide a way to influence several stakeholders by dealing with one key stakeholder.
Power: the ability of the stakeholder to affect the im plem entation of the health reform policy. Leadership: the willingness to initiate, convoke, or lead an action for or against the health
reform policy. Establishing whether or not the stakeholder has leadership will help policy-m akers and policy-m anagers target those stakeholders who will be policy-m ore likely to take active steps to support or oppose the policy ( and convince others to do so) .
The working group should review and adapt the characteristics and definitions provided in Annex 2-B to the policy being analyzed and the particular culture of the country. It is crucial to ensure that each m em ber of the working group understands the m eaning of the final definition for each characteristic.
Once the term s have been defined, a stakeholder analysis table can be created in a wordpro-cessing application or in a spreadsheet. ( A sam ple analysis table created in Microsoft Excel is provided in Annex 2-C.) The table should list stakeholder characteristics across the top row ( see Table 2.1) . This title row m ay vary depending on the exact characteristics and their definitions.
Develop the inter view questionnair e.
Once the working group has chosen and defined key stakeholder characteristics, a standard questionnaire should be developed for interviewing stakeholders. The stakeholders should not com plete the questionnaire them selves, but the interviewer should use the questionnaire to guide the conversation during the interview.
In developing the questionnaire, the working group should decide the m ost appropriate way to obtain the necessary inform ation, given the cultural context. Asking direct questions m ay seem the m ost efficient m ethod but could result in unreliable answers because the stakeholders m ay not be accustom ed to com m unicating in such a direct and candid m anner. Questions should be clearly stated, specific, and open-ended wherever possible, requiring the stakeholder to provide m ore than a sim ple “yes” or “no” answer. If necessary, several questions m ay be asked to obtain inform ation on one characteristic, but doing this repeatedly runs the risk of extending the inter-view beyond the ideal 2-hour tim e lim it. ( See the section below on “Develop the interinter-view proto-col.”)
The questionnaire also should include an introductory section that the interviewer can read to each stakeholder ( see Annex 2-D) . This introduction should state the objective of the inter-view, identify who is collecting the inform ation, explain what will be done with the inform ation, Table 2 .1 . Stakeholder Char acter istics and Table Titles
( full table in Annex 2 -C)
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and assure the stakeholder that all responses will rem ain anonym ous. The definition of the pol-icy under analysis and any term s that m ight be am biguous or unknown to the stakeholder should be explained during the interview. Such definitions and clarifications, however, should be provided only after the interviewer has explored and established the stakeholder’s level of understanding and knowledge of the policy in question.
The following section on interview protocol suggests a few m ore tips for im proving the inter-view process.
Develop the inter view pr otocol.
The working group should discuss and docum ent the protocol to be followed during the inter-view process. This protocol, and any other “rules” that the working group considers im portant to ensure the collection of consistent and accurate data, should be established in advance. To ensure consistency and objectivity, the following protocol is suggested:
Two-person interview team s should be used, with the interviewers representing different or-ganizations whenever possible.
Both interviewers should take notes, but only one should lead the interview.
Questions should be asked no m ore than twice; if the stakeholder still does not provide an answer, the interviewer should m ove on.
The interview should be term inated at the stakeholder’s request, even if questions rem ain. Im m ediately following the interview, the interviewers should type their notes into one
elec-tronic questionnaire per stakeholder. ( Interviewers should enter each answer under its corre-sponding question in the electronic questionnaire.)
The inform ation should be entered in the sam e words the stakeholder used.
As part of the protocol, each questionnaire should have a place for the interviewer to fill out the nam e and ID num ber for the stakeholder being interviewed and the date and city of the inter-view ( see Annex 2-D) . All interinter-viewers should be clear on how to adhere to the protocol before beginning the interviews.
Test the questionnair e.
Before interviewing the stakeholders, the working group should pretest the questionnaire by conducting interviews with nonpriority stakeholders ( i.e., those who were on an initial list but were cut when the list was shortened) . A pretest should be conducted to determ ine whether:
Interviewers are com fortable with the questionnaire The interviewee understands the questions
Answers provide the inform ation required for filling in the analysis table ( the table should be filled in for the pre-test interviews)
The interview does not take m ore than 2 hours
After analyzing the results of the pretest, the questionnaire and protocol should be m odified, if necessary, before proceeding with the priority stakeholder interviews.
Develop the r efer ence char t.
The final tool needed is the inform ation transfer reference chart or “reference chart” ( Annex 2-E) . This chart serves two purposes:
to provide a m eans of checking that all the stakeholder characteristics are covered in the in-terview questionnaire
to aid the working group in transferring the inform ation from the questionnaire to the stakeholder table.
2 -1 2 P o lic y T o o lk it fo r S tr e n g th e n in g H e a lth S e c to r R e fo rm
Table 2 .2 . Refer ence Char t ( question number s that per tain to each column on the stakeholder table)
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Step 5 : Collecting and Recor ding the Infor mation
Review existing infor mation.
Before beginning the interviews, the working group should gather and review secondary inform ation on the priority stakeholders. This inform ation should be m ore detailed than the inform ation that was reviewed in Step 3. It should include any written or spoken statem ents regarding the stakeholders’ positions on the policy, any goals or objectives of the organizations the stakeholders represent, the position of the stakeholders within their organizations ( with specific reference to the stakeholders’ control over resources) , and any data on the quantity or type of resources available to the stake-holders or their organizations.
Make inter view appointments.
As noted under Step 3, very little secondary inform ation is generally available on stakeholders, and the working group will likely have to interview all of the stakeholders from the final list. Even if there is an abundance of secondary inform ation, the working group m ay choose to interview all stakeholders to gain m ore insight into their opinions on the policy and other stake-holders.
To begin the process, interview appointm ents should be m ade with each stakeholder. Ideally, appointm ents should be m ade 1–2 weeks in advance by the working group m em ber( s) with enough influence to secure appointm ents with high-level and busy stakeholders. If necessary, the group should seek assistance from the sponsor or policym aker who is supporting the pro-cess.
The interviews should be scheduled at the tim e and place m ost convenient for the stake-holder. All attem pts should be m ade to secure an interview with the person indicated and not his or her representative. This includes rescheduling cancelled appointm ents, if necessary.
To interview stakeholders who work in a region outside the working group’s base city, two working group m em bers should travel to the region and interview any and all stakeholders from that region. This trip should be planned well in advance to ensure the availability of all stakeholders. A second option, if the working group does not have travel funds, is to m eet with the stakeholder when he or she m ay be in the working group’s base city. If neither travel nor a stakeholder visit to the base city is possible, the working group can interview the stakeholder by telephone. The telephone interview should be a conference call involving two interviewers.
Conduct inter views and r ecor d notes.
The interviewers should follow the protocol established by the group, with one person as the principle interviewer responsible for leading the conversation. Although the interviewer can
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2 -1 4 Policy Toolkit for Strengthening Health Sector Reform
attem pt to clarify the interviewee’s statem ents, he or she should not try to sum m arize responses. If the stakeholder does not understand a question, the interviewer can rephrase the question slightly, but any deviations from the original questionnaire should be noted. After two attem pts to ask and/or rephrase a question, the interviewer should m ove on.
Step 6 : Filling in the Stakeholder Table
This step of the process involves taking detailed and often lengthy answers from the interviews and arranging them into a m ore concise and system atized form at ( for anonym ity and to high-light the m ost significant inform ation) . By doing this, the working group can eventually develop clear com parisons am ong the different stakeholders and concisely present this infor-m ation to the policyinfor-m akers who will use it ( see Steps 7 and 8) . To conduct such coinfor-m parisons and analyses, the interview responses m ust first be translated into the stakeholder table. Accu-rately transferring interview responses to the table requires that the working group use all of the tools developed: the com pleted interview guides for each stakeholder, the reference chart, the definitions, and the stakeholder table.
It is useful to have those working group m em bers who served as interviewers participate in this process because they can generally recall the context within which certain stakeholders’ statem ents were m ade.Group m em bers should analyze the exact responses written in each stakeholder’s questionnaire, however, and should not rely on their m em ory.
During the process of adapting the tool, the working group should include, with each defini-tion, an explanation of how to fill in the stakeholder table for each term . These instructions are included in the definitions provided in Annex 2B, but the process for translating the m ore com -plex characteristics, such as position and power, is detailed below.
Deter mine the stakeholder s’ position.
The position of each stakeholder can be established by analyzing the following:
Inform ation directly reported by the stakeholder in the interviews
Indirect inform ation gathered through other stakeholders and secondary inform ation ( i.e., others’perceptions)
Interest inform ation.
To obtain indirect inform ation, each stakeholder interview m ust include specific questions about that stakeholder’s opinions of others ( see questions 13 to 17 in the Sam ple Stakeholder Interview Questionnaire, Annex 2-D) . Any such opinion should be entered in the stakeholder table ( Annex 2-C) in the row relating to that designated stakeholder and in the colum n for “others” colum n ( colum n E2, as shown in Table 2.3.)
Table 2 .3 . Column E of Stakeholder Table
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A stakeholder’s positions should be classified in colum ns E1, E2, and E3, using the estab-lished definitions for positions. The full spectrum of position classifications is presented in Fig-ure 2.2. If desired, low supporter ( LS) and low opponent ( LO) can be added, but the inform ation gathered usually does not allow for such a detailed disaggregation.
When determ ining the final position of each stakeholder ( colum n D3) , the working group needs to reconcile any differences between the position that is self-reported ( E1) and the posi-tion that is perceived by others ( E2) . Differences can be resolved in the following m anner:
When the stakeholder states that he or she is against the policy, this is assum ed to be accu-rate, albeit subjective, inform ation because there is little incentive for the stakeholder to m is-represent his or her position. For m oderate opponents ( MO) or opponents ( O) , self-reporting should determ ine the stakeholder’s final position.
In the case of the self-reported neutral or supportive stakeholder, it is im portant to cross-ref-erence the opinions of others because the stakeholder m ay have an incentive to m isrepresent his or her position.
When a discrepancy exists between the stakeholder’s self-reported position and that perceived by others, the working group m ust consider the relative weight of available inform ation. This includes the num ber of other stakeholders who disagree with the self-reported position, whether the stakeholder in question is perceived to be m oderately or strongly opposed to the policy, and any knowledge of the stakeholder’s past actions relative to sim ilar policies.
If considered carefully, deciding on the basis of “m ajority rules” is a possible m ethod for resolving position discrepancies. There m ust always be a balance, however, so that a person who is in full support of the policy is not m oved to a nonsupporting position unless the decision is unanim ous on the part of all other stakeholders interviewed. For exam ple, if a stakeholder who self-declares support for a policy is perceived to be against the policy by five other stakeholders, and one other stakeholder perceives the principal stakeholder as neutral, the working group could classify the stakeholder in question as m oderately opposed ( considering the 5 to 2 m ajor-ity and the lack of unanim ajor-ity on the part of other stakeholders) .
holder provides very general or am biguous answers to these questions, it m ay indicate that he or she is not strongly invested in the position stated or was not candid in his or her response to the question.
Fill in the r esour ces column and cr eate a power index for each
stakeholder .
Since the m ain source of a stakeholder’s power is his or her resources and ability to use them , the power index is derived from analyzing the two resource colum ns in the stakeholder table. Therefore, in order to fill in the " power" colum n for each stakeholder, the working group m ust first define the resource colum ns for each stakeholder according to the definition.
The resource category is divided into two parts: the quantity of resources that a stakeholder has within his or her organization or area and the ability to m obilize those resources.
Analysts should classify the quantity of resources as follows: 3 = m any, 2 = som e, 1 = few, and insert the appropriate num ber into colum n H1 of the stakeholder table. The ability of the stakeholder to m obilize resources should be quantified in term s of the following:
3 = the stakeholder can m ake decisions regarding the use of the resources in his or her organization or area
2 = the stakeholder is one of several persons that can m ake decisions regarding the use of resources
1 = the stakeholder cannot m ake decisions regarding the use of the resources.
This score should be inserted into colum n H2 ( see Table 2.4) .
Since " power" is defined here as the com bined m easure of the am ount of resources a stake-holder has and his or her capacity to m obilize them , the two resource scores for each stakestake-holder should be averaged, resulting in a power index between 3 and 1: 3 = high power, 2 = m edium power, and 1 = little power. The final rankings should be reviewed to ensure consistent scoring am ong all of the stakeholders.
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Step 7 : Analyzing the Stakeholder Table
Once the stakeholder table is com plete, the inform ation needs to be " analyzed." Such an analy-sis should focus on com paring inform ation and developing conclusions about the stakeholders' relative im portance, knowledge, interests, positions, and possible allies regarding the policy in question.
From the inform ation in the stakeholder table, the working group should be able to con-clude the following:
Who are the m ost im portant stakeholders ( from a power and leadership analysis) ? What is the stakeholders' knowledge of the policy?
What are the stakeholders' positions on the specific policy?
What do the stakeholders see as possible advantages or disadvantages of the policy ( interest analysis) ?
Which stakeholders m ight form alliances?
The specific steps for developing these five analyses are detailed below.
Car r y out a power and leader ship analysis.
Although the intent in prioritizing the stakeholder list ( see Step 3) was to select only those stake-holders with power and leadership, the first analysis is designed to use the inform ation from the table to further prioritize the stakeholders within the selected group interviewed. This second prioritization, based on actual data and a m ore select group, allows policym akers and m anag-ers to focus resources on addressing the concerns of the m ost im portant of the priority stake-holders.
The " im portance" of stakeholders is defined here as their ability to affect the im plem entation of the policy. Since power and leadership are the characteristics that determ ine a stakeholder' s ability to affect or block the im plem entation of a policy, these two characteristics are the basis for the first " im portance" analysis.
For this analysis, the working group should divide the stakeholders into three groups ( see Table 2.5) :
Group 1: those who have leadership and high power ( level 3) Group 2: those who have leadership and m edium power ( level 2)
Group 3: those who do not have leadership but have high to m edium power ( level 2 or 3) .
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2 -2 0 Policy Toolkit for Strengthening Health Sector Reform
The above grouping is based on the prem ise that those with leadership and power will be m ost able to affect policy im plem entation, although powerful stakeholders who lack leadership m ay still be able to affect the im plem entation through their power alone.
Identify the stakeholders m aking up these three groups by organization rather than by nam e in order to preserve their anonym ity. Each of the three groups should have a nam e ( it could be sim ply group 1, 2, or 3) .
Som e of the stakeholders m ay not fit into any of these groups, i.e., they m ay have no leader-ship and low power. Such stakeholders m ay be rem oved from the analysis at this point so that attention can be focused on those stakeholders within the power/leadership priority groups. When a sm all num ber of stakeholders are being analyzed, or if the working group wants to rep-resent all stakeholders in the power/leadership analysis, a fourth group can be added for those with no leadership and low power ( level 1) .
Analyze knowledge data.
The stakeholders' level of knowledge related to the policy is often of interest to policym akers and m anagers. This level of knowledge can be presented as a general conclusion, especially if it is sim ilar for the m ajority of the stakeholders, or the stakeholders can be divided by their level of knowledge ( 1, 2, or 3) . The latter option is useful for targeting a com m unication strategy for a specific group of stakeholders, nam ely those with the lowest knowledge of the policy. These stakeholders would appear in Group 1 for knowledge level.
The inform ation found in the knowledge data can be crossed with the power/leadership analysis to highlight the im portance level of the stakeholders with a low knowledge level. This cross-analysis will result in an even sm aller priority group for targeting com m unication strate-gies.
The knowledge data also can be cross-referenced with the position of the stakeholders to determ ine if those opposed to the policy have a consistently low level of knowledge. This would indicate to the policym aker or m anager prom oting this policy that com m unicating or advocat-ing the objectives and basic tenets of the policy could reduce the opposition.
Table 2 .5 . Example Results of Power /Leader ship Analysis
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Analyze stakeholder s' positions.
In analyzing the position inform ation from the table, the following aspects can be determ ined:
Total num ber of supporters
Im portance of supporters ( cross-reference with power/leadership analysis) Knowledge of supporters ( cross-reference with knowledge data)
Advantages and disadvantages of policy im plem entation to the supporters ( cross-reference with interest data)
Knowledge of whether these supporters are internal or external to the organization develop-ing the policy ( cross-reference with the internal/external classification)
Support " clusters" : stakeholders in the sam e sector who support the policy ( cross-reference with organization inform ation)
Total num ber of opponents
Im portance of opponents ( cross-reference with power/leadership analysis) Knowledge of opponents ( cross-reference with knowledge data)
Advantages and disadvantages of policy im plem entation to the opponents ( cross-reference with interest data)
Knowledge of whether these opponents are internal or external to the organization develop-ing the policy ( cross-reference with the internal/external classification)
Opposition " clusters" : stakeholders in the sam e sector who oppose the policy ( cross-reference with organization inform ation)
Neutral stakeholders, their im portance, knowledge, and interests
Although the working group can identify such conclusions directly from the analysis table, the developm ent of a position m ap often helps analysts to pull out and organize the inform a-tion needed to m ake conclusions. For exam ple, support or opposia-tion " clusters" can be easily identified on a position m ap. Step 8, Using the Inform ation, discusses how to develop the posi-tion m ap. This m ay be useful to the working group in conducting the posiposi-tion analysis as well as in presenting the inform ation to policym akers and m anagers.
Analyze inter est data.
The interest data can be used either in conjunction with other analyses or alone as general con-clusions. In cross-referencing the interest data with other data, the policy im plem entation advantages and disadvantages identified by the stakeholders can be used to explain their posi-tions or to em phasize their knowledge of the policy ( i.e., irrelevant advantages and disadvan-tages m ay represent a m isunderstanding of the policy) . The interest data also can be cross-refer-enced with the power/leadership data to indicate what the m ost im portant stakeholders m ay have to lose or gain from policy im plem entation.
stake-2 -stake-2 stake-2 Policy Toolkit for Strengthening Health Sector Reform
holders identify the sam e advantages and disadvantages. In this case, the working group can identify the concerns of the m ajority of the stakeholders regarding policy im plem entation.
Analyze alliances.
Possible stakeholder alliances can also be identified from the table inform ation. The alliances can be identified in two ways:
by referring to the analysis table to see if stakeholders m entioned organizations that they would work with to dem onstrate for or against the policy
by referring to the position " clusters" ( the stakeholders with sim ilar positions and within the sam e organization or subsector) . As previously stated, the " clusters" can be easily identified with the developm ent of a position m ap.
The alliance inform ation should be cross-referenced with the position data to identify those alliances that m ay be potential sources of support, as well as those that m ay work together to oppose the policy. The working group can suggest or encourage policym akers to develop specific strategies based on these key alliances, either to reinforce a potentially supportive alliance or to separate a potentially threatening alliance.
The alliance data can also be cross-referenced with the power/leadership analysis results to highlight those alliances that are potentially the m ost supportive or threatening to the policy im plem entation.
Develop additional r esults.
In addition to the inform ation listed on the stakeholder table, other inform ation gained from the interviews can be used to develop key results and conclusions. When transferring the infor-m ation froinfor-m the questionnaires to the table, the working group should note that the following inform ation m ay be relevant:
Stakeholders who were not included in the priority list but were m entioned often by those in-terviewed
Stakeholders' global im pressions of other stakeholders or their organizations Suggestions for the im plem entation of the policy
Any expectations that the m ajority of the stakeholders have in relation to the policy process.
By analyzing inform ation related to these areas, as well as the five basic analysis results pre-viously m entioned, the working group can develop a list of conclusions or results to be presented to the policym akers.
Step 8 : Using the Infor mation
Using the inform ation generated by the preceding analysis is an integral part of the stakeholder analysis process. The working group, by virtue of its role in inform ation-gathering and analysis, is responsible for organizing, dissem inating, and explaining the results in a way that will ensure that the sponsor or other policym akers and m anagers can use the inform ation to ta ke a ction .
The use of the inform ation generated by the stakeholder analysis should be discussed during Step 1, Planning the Process, and should be reviewed again once the results have been analyzed. As m entioned, there are various ways to use the inform ation from a stakeholder analysis— to provide input into other analyses, to develop action plans to increase support for a reform policy, or to guide a participatory, consensus-building process.
This section offers guidelines on how to present the results. If the policym akers and m anagers plan to use the results obtained through the stakeholder analysis to take concrete, and possibly " behind the scenes," actions to increase stakeholder support, only those persons involved in im plem enting the follow-up actions should be included in the presentation and discussion of the results. If the purpose of the presentation is to share the results to build consensus am ong the stakeholders, then all stakeholders should be invited to attend. Although these guidelines address general issues about presenting the results, if the sponsor or other policym akers plan to use the results to build consensus, they should work with professional facilitators to guide the discussion.
Gener al Results Pr esentation For mat
Two persons from the working group should be selected to m ake the presentation, and the rem ainder of the group should be available to help answer any questions that arise. A date should be set when the sponsor and other relevant policym akers or stakeholders can m eet for at least a 2-hour presentation and discussion session.
The presentation m ay include a short introduction on the stakeholder analysis, but it should focus on the results of the analysis, not on the process. Since policym akers and m anagers m ust prioritize and focus on the m ost im portant inform ation, the presentation should be a concise synthesis, not a review of all the inform ation obtained or the entire stakeholder table. If the results will be presented for a consensus-building process, the key areas that the stakeholders will discuss should be presented.
Th e rem ain der of th is section provides som e suggestion s for presen tin g key in form a tion .
Pr esentation of Power /Leader ship Analysis Results
Who is important?
2 -2 4 Policy Toolkit for Strengthening Health Sector Reform
Microsoft PowerPoint™ is an effective tool for such a presentation because it has colored squares that can be used to represent the power/leadership level of each stakeholder consistently throughout the presentation. For visual em phasis, m ore intense colors can be used to represent higher power/leadership indexes, and, therefore, higher im portance. For reasons of anonym ity, the boxes should be labeled with organizations' nam es and not individual stakeholders’ nam es or job titles. ( See Figure 2.4.) Other visual aids m ay be used if PowerPoint™ is not available.
Figur e 2 .4 . Sample of How to Use Power Point to Pr esent Power /Leader ship Analysis Results
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The second finding— the supporting, neutral, or opposing positions of stakeholders— can be presented using a position m ap developed with PowerPoint™ or other visual aids. The position m ap ( see Figure 2.5) can quickly illustrate which actors support or oppose a policy, how im por-tant that support or opposition is ( i.e., by color) to the success of the policy, and where these stakeholders are by sector. Colored boxes representing each actor from the three power/leader-ship groups should be placed on the m ap in accordance with the sector to which they belong ( vertically) and their stakeholder position as established in the stakeholder table ( horizontally) .
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Before the stakeholders can be located on the m ap, the m ap rows need to be labeled. The organization sponsoring the policy should be placed in the " policy origin" row ( row in the cen-ter of the below m ap) . The other rows should be labeled with the sector categories used in the stakeholder list ( i.e., international/donor, national political, public, labor, etc.) . The rows should be labeled in order of the proxim ity of the sector to the policy origin. For exam ple, for a policy being developed by a centralized group in the MOH, the central MOH sector is closest to the policy origin and is given the row im m ediately adjacent to the policy origin row. In this exam ple, the labor sector, which is external to the MOH and far from the direct influence of the policy developers, is placed farthest from the center row. Once all rows are labeled, the stake-holders can be placed within the row that represents their sector, or overlapping two rows if they act within two sectors.
In adapting the m ap, the colum n titles, which represent the positions of the stakeholders, should not need to be changed. In placing the colored boxes ( i.e., stakeholders) on the m ap, those who are strong supporters ( S) should be placed on the far left of the first colum n, while m oderate supporters ( MS) should be on the right side of the first colum n within the row that rep-resents their sector. Those who are strong opponents ( O) should be placed on the far right of the last colum n, while m oderate opponents ( MO) should be placed on the left side of the last colum n within their sector' s row. Any neutral actors ( N) should be placed in the m iddle colum n, in the row representing their sector.
If colored squares are used, the following conclusions can be presented:
Total num ber of supporters
Im portance of supporters ( cross-reference with power/leadership analysis)
Whether these supporters are internal or external to the organization developing the policy ( cross-reference with the internal/external classification)
Support " clusters" : stakeholders in the sam e sector who support the policy Total num ber of opponents
Im portance of opponents ( cross-reference with power/leadership analysis)
Whether these opponents are internal or external to the organization developing the policy ( cross-reference with the internal/external classification)
Opposition " clusters" : stakeholders in the sam e sector who oppose the policy Neutral stakeholders and their im portance.
Pr esentation of Knowledge Data
As suggested in Step 7, the knowledge data can be presented in two ways: as a general conclu-sion, especially if the level of knowledge is sim ilar for the m ajority of the stakeholders, or as a graphic representation of the three levels of knowledge.
The graphic representation of the three knowledge groups is particularly useful in cross-ref-erencing the power/leadership inform ation with the use of colored boxes. Using a slide sim ilar to that seen in Figure 2.6, the working group presenters can highlight for the audience the level of knowledge of the m ost im portant stakeholders.
Figur e 2 .6 . Power Point Pr esentation of Knowledge Data
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Who might work together?
Although alliances can be identified by " clusters" on the position m ap, the working group can identify additional alliances that are not evident on the position m ap. Since an audience often cannot sim ultaneously absorb all of the inform ation presented on a m ap, presenters also m ay want to use a slide sim ilar to the one shown in Figure 2.7 to em phasize alliances.
[image:33.612.190.537.274.505.2]Pr esentation of Other Results/Conclusions
After presenting the initial findings, the group should then present key overall conclusions, repeating particularly im portant conclusions dem onstrated in the position m ap and other graphics. This inform ation should focus on what the policym akers and m anagers need to con-sider when im plem enting the policy. These conclusion statem ents should be concise and clear and m ay be presented in a list form at. ( Box 2.5)
Pr esentation of Recommended Str ategies
Finally, the working group presenters should always place the results within the context of rec-om m ended actions and next steps so that the sponsor and other policym akers or m anagers know how to use the results.
To guide these follow-up actions, the working group should develop strategies to achieve the following five basic goals:
Maintain the support of those stakeholders who are currently supporters Increase power and leadership of the supporters
Convert the opponents to supporters
Weaken the power and leadership of the opponents
Convert the neutral stakeholders into active supporters ( i.e., convince them to support the policy and increase their power and leadership where necessary) .
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Two types of strategies can then be identified to m eet those goals:
General strategies: the working group should analyze the interests, concerns, and m isunder-standings com m on to m ost stakeholders. ( Box 2.6)
Strategies for specific stakeholder groups: the working group should consider the position of each stakeholder, his or her interests ( colum n F of the stakeholder table) , and the five basic strategy goals. The working group should develop spe-cific ways of addressing the concerns of the individual stake-holders and securing their a ctive support ( i.e., increasing their power and leadership so they can dem onstrate this sup-port) . Figure 2.8 offers an exam ple of how to present this in-form ation in PowerPoint™.
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[image:35.612.200.545.375.637.2]The working group should present these strategies to the sponsor and other policym akers or m anagers present, with the following caveats:
To be m ost effective, certain strategies m ay need to rem ain confidential, known only by a se-lect group of policym akers im plem enting the policy.
The strategies should be developed in further detail through concrete a ction pla n s, com -m u n ica tion pla n s, and n egotia tion pa cka ges.
The im plem entation of the strategies will require the com m itm ent of additional tim e and re-sources from the sponsor.
The im plem entation of the strategies will require the developm ent of a select group of pro-fession als trained in com m unication, facilitation an d m ediation, and n egotiation tech-niques.
It is not always necessary or feasible to im plem ent all of the strategies im m ediately. In present-ing the strategies, the workpresent-ing group should identify a few, select priorities for im m ediate action ( i.e., next steps) by the sponsor or other policym akers or m anagers. Depending on the results, the working group m ay recom m end im plem entation of one key strategy for all stakeholders, or im plem entation of several strategies to address the needs of several stakeholders. In the latter case, the working group should recom m end which stakeholders should be targeted for strategy im plem entation, given the lim ited resources generally available for im plem entation. The group can recom m end that the following stakeholders be targeted for the first stage of strategy im ple-m entation:
Supporters with little power and leadership: focus on ways of increasing the power and lead-ership of these stakeholders.
Neutral stakeholders with m edium to high power and leadership: focus on convincing the stakeholders to support the policy and increasing their power and leadership where neces-sary.
Opponents with high power and leadership: focus on negotiating for the opponents' support and decreasing their power and leadership if they rem ain opposed.
Figure 2.9 illustrates a visual prioritization of stakeholders to be targeted for the initial strat-egy im plem entation.
Once the stakeholder groups are prioritized, the working group should present the stake-holders' interests and the specific strategies for addressing their needs. This can be done either in a list or in a table, created in a wordprocessing application or in a PowerPoint™ figure, highlighting the power and leadership index of the priority stakeholder with the colored boxes ( e.g., as in Figure 2.9) .
2 -3 2 Policy Toolkit for Strengthening Health Sector Reform
m anagers who attended the presentation to check on the status of the im plem entation of the strategies.
Policym akers and m anagers can use the guidelines and tools found in the subsequent sec-tions of this toolkit to develop and im plem ent the strategies identified here related to com m uni-cation, advocacy, and conflict m anagem ent and negotiation.
Figur e 2 .9 . Matr ix for Identifying Stakeholder s To Be Tar geted by Str ategies
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Brinkerhoff, Derick. June 1998. From Design to Im plem en ta tion : Sta kehold er An a lysis in a PHC Project in In d ia. Bethesda, MD: Abt Associates Inc.
_ _ _ _ _ . April 1997. PHR Trip Report: Sta kehold er An a lysis in In d ia. Bethesda, MD: Abt Asso-ciates Inc.
Crosby, Benjam in L. March 1992. " Stakeholder Analysis: A Vital Tool for Strategic Managers." Techn ica l Notes, no. 2. Washington, DC: Im plem enting Policy Change Project for the US Agency for International Developm ent ( USAID) .
_ _ _ _ _ . April 1992. " Managem ent and the Environm ent for Im plem entation of Policy Change: Part One." Techn ica l Notes, no. 4. Washington, DC: Im plem enting Policy Change Proj ect for the US Agency for International Developm ent ( USAID) . _ _ _ _ _ . April 1992. " Managem ent and the Environm ent for Im plem entation of Policy
Change: Part Two." Techn ica l Notes, no. 5. Washington, DC: Im plem enting Policy Change Proj ect for the US Agency for International Developm ent ( USAID) . Lindenberg, Marc, and Benjam in Crosby. 1981. Ma n a gin g Developm en t: The Politica l
Dim en sion. Hartford, CT: Kum arian Press.
Reich, Michael R. March 1993. " Political Mapping of Health Policy: Draft Guidelines." Boston, MA: Harvard School of Public Health.
Reich, Michael R., and David M. Cooper. 1996. Policy Ma ker: Com pu ter-Aid ed Politica l An a l-ysis: Im provin g the Art of the Fea sib le. Brookline, MA: PoliMap. ( To order, contact Poli-Map, 74 Arm ory St., Brookline, MA 02446-3909 USA.)
Schm eer, Kam m i. Septem ber 1998. “Process for Developing an Interest Map in Ecuador,” Tech-n ica l Report no. 23. PHR Project. Bethesda, MD: Abt Associates Inc.
Annex 2 -A
Sample Gener al List of Stakeholder s
The following table illustrates general inform ation on priority stakeholders to be interviewed, with a justification for each group' s inclusion in the analysis.
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Instr uctions for Filling in Stakeholder Table
A. I.D. Number
The distinct num ber given to each stakeholder on the questionnaire.
B. Position and Or ganization
The position the stakeholder has and the organization for which he or she works.
C. Inter nal/Exter nal
Internal ( I) stakeholders work within the organization that is prom oting or im plem enting the policy; all other stakeholders are considered external ( E) .
D. Knowledge of Policy
This colum n is divided into two parts. The first part, D1, is the level of accurate knowledge the stakeholder has regarding the policy under analysis. This knowledge should be rated from 3 to 1: 3 = a lot; 2 = som e; 1 = none. Final rankings should be reviewed to ensure consistent scoring am ong all of the stakeholders.
The second part of the colum n, D2, is to record how each stakeholder defines the policy in question. The inform ation gathered in question #3 of the questionnaire should be noted here in the stakeholder’s own words.
E. Position: Suppor ts/Opposes/Neutr al
Position refers to the stakeholder’s status as a supporter or opponent of the policy. The position of the stakeholder can be obtained by gathering inform ation directly from the stakeholder ( i.e., self-reporting) and through inform ation gathered indirectly from other stakeholders or second-ary inform ation ( i.e., others’ perceptions) . Thus, the reporting in this colum n represents the self-reported classification ( colum n E1) , the classification by others ( colum n E2) , and a final classification considering both ( colum n E3) . The position of the stakeholder should be reported from this final classification ( colum n E3) .
clear opinion, or whose opinion could not be discerned, are considered neutral ( N) . Those who express som e, but not total, agreem ent with the policy should be classified as m oderate support-ers ( MS) . Finally those who express som e, but not total, opposition to the policy should be clas-sified as m oderate opponents ( MO) . Thus, in colum n E1, the position of the stakeholder as they state it in the interview should be entered ( S, MS, N, MO, or O) .
In colum n E2, the position of the stakeholder as perceived by other stakeholders and/or from secondary inform ation should be entered with a reference to the ID num ber of the person who stated that opinion. For exam ple, S 32 would m ean that stakeholder num ber 32 stated in his or her interview that the stakeholder under analysis would support the policy. In colum n E2, the position of the stakeholder as others perceive it should be entered ( S, MS, N, MO, or O) with the ID num ber for each opinion.
Lastly, in colum n E3, the final determ ination for the position of the stakeholder should be entered ( after entering data from all interviews) . This position should take into account the self-reported position as well as other stakeholders’ opinions. S, MS, N, MO, and O can be entered in this colum n.
F. Inter est
The interest the stakeholder has in the policy, or the advantages and disadvantages that im ple-m entation of the policy ple-m ay bring to the stakeholder or his or her organization. Advantages and disadvantages m entioned by each of the stakeholders should be entered into this colum n in as m uch detail as possible, since the inform ation will be used prim arily in developing conclusions and strategies for dealing with the stakeholders’ concerns.
G. Alliances
“A union or relationship” ( Webster, 1984) . Alliances are form ed when two or m ore organiza-tions collaborate to m eet the sam e objective, in this case to support or oppose the policy in ques-tion. Any organizations that are m entioned by the stakeholder in the questions related to this item should be entered in this colum n.
H. Resour ces
“A source of support or aid” ( Webster, 1984) . Resources can be of m any types — hum an, finan-cial, technological, political, and other. The analysts should consider the stakeholder’s access to all of these resources.
The resource category is divided into two parts: the quantity of resources that a stakeholder has within his or her organization or area, and the ability to m obilize those resources. The quantity of resources should be classified by the analysts as 3 = m any, 2 = som e, 1 = few and inserted into colum n H1 of the stakeholder table. Final rankings should be reviewed to ensure consistent scoring am ong all stakeholders.
resources
1 = the stakeholder cannot m ake decisions regarding the use of the resources.
This score should be inserted into colum n H2. For exam ple, if the stakeholder has personnel that work for him or her, it can be concluded that the stakeholder has the ability to m obilize these resources because he or she has direct influence over them .
I. Power
“The capacity or ability to accom plish som ething;…strength, force or m ight” ( Webster, 1984) . Here, power refers to the ability of the stakeholder to affect the im plem entation of the health reform policy due to the strength or force he or she possesses.
Since “power” is defined here as the com bined m easure of the am ount of resources a stake-holder has and his or her capacity to m obilize them , the two resource scores im plied should be averaged, resulting in a power index between 3 and 1: 3 = high power, 2 = m edium power, and 1 = little power. The final rankings should be reviewed to ensure consistent scoring am ong all stakeholders.
J. Leader ship
Annex 2 -C
Sample Stakeholder Table
Annex 2 -D
Sample Stakeholder Inter view Questionnair e
Date: _ _ _ /_ _ _ /_ _ _ _ _ ID #: _ _ _ _ _ City: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Intr oduction:
We are from ( orga n iza tion n a m e) and we are conducting a study on behalf of ( spon sor n a m e if a ppropria te) to explore the opinions of several im portant actors who are interested in the im proved m anagem ent of the Ministry of Health. As an im portant actor in the health sector, it is crucial for us to obtain your opinion and that of your organization.
We plan to conduct about 35 to 40 interviews to produce a general report on the opinions of the m ajor health sector actors. The inform ation obtained through these interviews will be for the direct use of the consultants on the analysis team , and will be presented in a general report to ( in sert orga n iza tion for whom report is d on e if a ppropria te) without identifying individ-ual opinions.
We would now like to ask you a few specific questions about your opinion regarding the im plem entation of deconcentration of the MOH.
Your Opinion:
1. Have you heard of the Ministry of Health policy on " deconcentration" ? 2. If so, how did you hear of it?
3. What do you understand " deconcentration of the MOH" to m ean?
The Ministry of Health has defined " deconcentration" as " perm anently delegating control over resources to the Provincial Directors, Hospital Dir
